Beyond the Autoimmune Spectrum, Evaluating Ovarian Health in Systemic Lupus Erythematosus Patients: A Case-Control...

Area of Science:

• Reproductive Endocrinology
• Autoimmune Diseases
• Gynecologic Health

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune condition impacting multiple organs.
• Emerging evidence suggests SLE negatively affects fertility and ovarian reserve, even in moderate disease stages.
• SLE's direct influence on ovarian function necessitates further investigation into reproductive health outcomes.

Purpose of the Study:

• To quantitatively assess ovarian reserve in women with SLE.
• To compare Anti-Müllerian hormone (AMH) levels and antral follicle counts (AFC) between SLE patients and healthy controls.
• To explore the relationship between SLE disease activity and ovarian reserve markers.

Main Methods:

• A case-control study involving 150 SLE patients and 150 age-matched healthy controls.
• Ovarian reserve was evaluated using serum AMH levels and AFC measurements.
• Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) was used to assess disease activity.

Main Results:

• SLE patients exhibited significantly lower mean serum AMH levels compared to controls (1.34 ± 1.16 vs. 2.47 ± 1.48 ng/mL, p < 0.001).
• Both left, right, and mean AFC were significantly reduced in the SLE group (e.g., mean AFC: 2.62 ± 1.56 vs. 5.17 ± 1.96, p < 0.001).
• Uncontrolled SLE (SLEDAI-2K > 4) was associated with significantly lower AMH levels (p < 0.001).

Conclusions:

• Women with SLE demonstrate diminished ovarian reserve compared to healthy individuals.
• Periodic evaluation of AMH and AFC is recommended for SLE patients to monitor potential accelerated decline.
• Early detection and management of reduced ovarian reserve are vital for fertility preservation in SLE.